alprazolam, Xanax, Xanax XR, Niravam (cont.)

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DOSING: Alprazolam may be taken with or without food.

The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.

The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily. The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.

DRUG INTERACTIONS: Ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone (Serzone), cimetidine (Tagamet), and fluvoxamine (Luvox) increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam. Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.

Carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol) and rifampin reduce the effect of alprazolam by increasing metabolism and elimination of alprazolam in the liver.

PREGNANCY: Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy.

NURSING MOTHERS: Alprazolam is excreted in breast milk and can affect nursing infants. Therefore, it should not be used by women who are nursing.

SIDE EFFECTS: The most frequent side effects of alprazolam taken at lower doses are drowsiness or lightheadedness, which probably reflect the normal actions of the drug. Side effects of higher dosages (those used for panic attacks) include fatigue, memory problems, speech problems, constipation, and changes in appetite with resultant changes in weight.

Medically Reviewed by a Doctor on 4/5/2013


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